Let’s Talk About BWAP (Body Worn Absorbent Products)!

Introduction

Body-worn absorptive products (BWAP) are the most prevalent treatment to contain urinary and fecal incontinence. The products are grouped into two different categories, disposable and reusable. However, reusable product use may be considered an alternative only in the extended care setting.

BWAP Products

There are a variety of body worn absorbent products (BWAP) available. These products include pads, briefs, and pull-ups with a four-layer structure to absorb and contain urine and liquid stool. The recommended terms used for each product describe the product’s designs and avoid using words for baby/toddler products. Individual body size is considered the selection of BWAP. In addition, there is a limited selection of products for morbidly obese individuals. The consideration of the product is the length of the absorptive area to cover the front and back and fit around the abdominal area, legs, and skin folds. This blog aims to guide the caregiver or individual in selecting body-worn absorptive products.

Light Daytime Incontinence

The first-line product selection is disposable incontinence pads. Incontinence pads absorb up to 100 milliliters of urine. Menstrual pads can absorb up to 15 milliliters of fluid but are not designed for incontinence. Disposable pads for fecal incontinence are positioned over the anus and buttock area. However, if the incontinence pads are inadequate to manage light liquid fecal or mucus incontinence, consider the use of pull-up or brief.

  • Female considerations:  First-line treatment selection is disposable incontinence pads designed for female use. Based on individual preference, menstrual pads are an alternative for infrequent incontinence.
  • Male considerations: The first-line treatment selection is disposable incontinence pads designed for male use. Menstrual pads are not recommended as an alternative for men.

Moderate to Heavy Incontinence

Incontinence products with superabsorbent polymer (SAP) technology contain moderate to a large amount of incontinence. SAP’s can absorb a large amount of liquid and contain up to 300 times their weight.

  • Ambulatory or toiletable individuals: The first line of treatment is pull-ups. An alternative is disposable briefs with resealable tabs.
  • Non-ambulatory individuals: The treatment for daytime and nighttime is disposable briefs.

Night Time considerations:  Wraps and booster pads are used with briefs or pull-ups to maximize containment and minimize sleep interruption. 

  • Wraps are a multilayer disposable absorptive pad wrapped around the penis to wick away urine.
  • Booster pads are absorbent flow-through pads for female and male use. 
  • Breathable products to protect clothing and mattress are preferred over unbreathable plastic-backed or rubber products that increase heat and moisture to the skin causing skin dermatitis.

Conclusion

There are many factors to consider for selecting body-worn absorbent products (BWAP). There are multiple designs of BWAP to manage incontinence. Consideration of shape and contour, and fit to maximize effectiveness and comfort. Performance of the products and consideration of individual personal preference. During the assessment, these factors can aid in selecting products for containment of incontinence.

Disclaimer

The views and opinions stated in this blog are exclusively those of the author and do not reflect those of iWound, its affiliates, or partnered companies.

References

1.  Davis, N. J., & Wyman, J. F. (2020, February). Managing Urinary Incontinence. American Journal of Nursing, 120(2), 55-60.

2.  Fader, M., Cottenden, A., Chatterton, C., Engqvist, H., Eustice, S., Newman, D. K., . . . Haylen, B. (2020, July 31). An International Continence Society (ICS) report on the terminology for single-use body-worn absorbent incontinence products. Neurourology and Urodynamics, 1-9. doi:10.1002/nau.24488

3.  Fader, M., Cottenden, A. M., & Getliffe, K. (2007). Absorbent products for light urinary incontinence in women. The Cochrane database of systematic reviews, 2007(2), CD001406. https://doi.org/10.1002/14651858.CD001406.pub2

3. Falloon, Sabrina S.; Abbas, Shabira; Stridfeldt, Chatrine; Cottenden, Alan The Impact of Microclimate on Skin Health With Absorbent Incontinence Product Use, Journal of Wound, Ostomy and Continence Nursing: July/August 2018 – Volume 45 – Issue 4 – p 341-348

doi: 10.1097/WON.0000000000000449

4. Gray, M., Kent, D., Ermer-Seltun, J., & McNichol, L. (2018, May/June). Assessment, Selection, Use, and Evaluation of Body-Worn Absorbent Products for Adults With Incontinence. Journal Wound, Ostomy, Continence Nurs., 45(3), 243-264.

5.  Kanerva Rice, S., Pendrill, L., Petersson, N., Nordinder, J., & Farbrot, A. (2018, September/October). Rationale and Design of a Novel Method to Assess the Usability of Body-Worn Absorbent Incontinence Care Products by Caregivers. Journal Wound, Ostomy, Continence Nurs., 45(5), 458-464.

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